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On 30 January 1962, a girls’ school in Kashasha, twenty-five miles outside of Bukoba on the coast of Lake Victoria in the state of Tanganyika (present day Tanzania), was suddenly afflicted with a bizarre case of spontaneous laughter. Three girls began laughing and couldn’t stop. Stranger still, the laughter spread throughout the school and eventually into surrounding villages. The laughter lasted on average seven days and sometimes as long as six months. By the time the epidemic ended, 14 schools had to be shut down and 1000 people were infected. What happened?

It was a stressful time for the people of Tanganyika in the early 1960s as it emerged from almost a century of European colonialism. Germany annexed the territory during the Scramble for Africa in the 1880s and named it German East Africa. The German defeat during the First World War led to the British takeover of the colony in 1916, and it remained a British colony until 1946. The United Nations mandated that Britain prepare the country for independence after the Second World War, and Tanganyika became independent on 9 December 1961.

The movement towards independence was accompanied by modern ideas about government, particularly surrounding education. The traditional tribal culture of the region was confronted with new methods of instructions, which separated students from their families with new and different expectations. Under British rule, a “racial education” system had divided Africans, Asians (mostly Indians), and Europeans in the state, with each being given vastly uneven resources and educations. The Europeans were at the top of the ladder, followed by Asians, while Africans were at the bottom. The newly independent government of Julius Nyerere immediately abolished this colonial system by creating a new integrated and modern education system for Tanganyika. While Nyerere believed that the modernization of Tanganyika was for the best, its peoples were not as prepared for these changes. Weeks from independence in January 1962, a laughter epidemic broke out among the new students.

Julius Nyerere holding a sign demanding complete independence from the British Empire in 1961, Photo from the National Archive via Wikipedia.

According to linguist Christian F. Hempelmann, these social and cultural changes are currently the best guess for the reason behind the uncontrollable laughter that afflicted schools in northwest Tanganyika. Tests at the time found no traces of toxic substances or food poisoning that could have caused the disease. A virus is unlikely, since it was widespread without clear transmission by individuals and sometimes reoccurring within the same community after it had already stopped. While many causes can be ruled out, and we should be clear that we still aren’t sure what caused it (and never can be), it is likely that the people of Tanganyika suffered from mass psychogenic illness.

Mass psychogenic illness has a long and strange history throughout the world. Many cases of mass psychogenic illness followed periods of extreme hardship. One of the most well-known and well-documented cases was Strasbourg’s Dancing Plague of 1518 and other dancing plagues that afflicted Europe in the 16th century. The Strasbourg region had experienced famine, plague, and extreme cold in the years before 1518, and many explained these unfortunate events through divine or demonic causes. Likewise, the mass hysteria of the dancing plague was understood as yet another magical or spiritual affliction that cause its victims to dance incessantly. Contemporary beliefs of the time had a limited ability to understand the bizarre illness. Many historians have written about the Dancing Plagues as part of the history of madness. H.C. Erik Midelfort’s A History of Madness in Sixteenth-Century Germany argues that Europeans did not understand “madness” as a mental illness, as we do today. More often, moral explanations collided with natural ones, as contemporary observers wondered if the city of Strasbourg had sinned, been cursed, or if the dancing was the cure for or the symptom of the illness.

The Saint John's Dancers in Molenbeeck (1592) by Pieter Brueghel the Younger. It was thought that music helped the dancers, and we can see villagers helping the exhausted dancers continue.

Today we are more certain about what is happening during these episodes, but is it still not clear why and when they happen. More recently, Africa has seen many instances of psychogenic illnesses, as recently as February 2009, including symptoms like incessant running, wildly shouting, and attacking other. Other cases occurred in the same region around Lake Victoria as the Tanganyika laughing epidemic, highlighting the socio-cultural stress in the area during decolonization. Scientists and psychologists generally believe that these, and historical examples, are instances of mass psychogenic illness. Unstoppable laughter and other overpowering urges are an unconscious method of escaping a new and unfamiliar situation. Other cases are more directly tied to traumatic stress in war-torn regions that have collectively experienced physical and mental trauma, like Strasbourg in 1518. Yet why does it happen to some and not others? We are as lost as early-modern Europeans!

There is also evidence that this illness changes depending on where it manifests. The most bizarre cases of mass psychogenic illness to Western observers involve physical actions, like dancing or running, but it does not mean that we are immune to its occurrence. One memorable instance was the anthrax scares of the early 21st century, when 2300 false anthrax alarms were reported during the first two weeks of October 2001. For Americans after 9/11, fear and extensive reporting about Anthrax being sent to public figures led to widespread knowledge about its symptoms and danger. In other words, the symptoms of mass psychogenic illness reflected the context and culture of Americans in the months after 9/11, not as a single set of symptoms common across the world.

In Tanganyika, laughter and running were considered part of how sickness might manifest, just as dancing was in the Middle Ages. Today in the West, we accept another set of clinical symptoms as part of “disease” and consequently it is unlikely we would see spontaneous dancing or laughter as being “sick.” Mass psychogenic illness is a manifestation of sickness in order to escape something, be it mental or physical stress, and thus we present different symptoms to meet the terms of that escape. Laughter or dancing is unlikely to earn you a day off work, but exposure to anthrax would.

Unlike more easily explainable physical diseases, they are not the result of viruses of bacteria, but they are fascinating because they reflect our ideas about diseases. In historic and modern cases alike, psychogenic diseases are a result of a culturally constructed framework of illness.

Of course, how we understand and define diseases has never been solely a result of biological causes or scientific knowledge. India’s doshas, Greek and Roman humors, or China’s Five Elements all hint at scientific explanations of disease cloaked in metaphorical language – language that is rooted in their cultures. They clearly understood medicine as part of the natural world, but lacked the ability to discuss it accurately. Instead, they described their experiences with disease the best they could using literal imagery, religious concepts, and other cultural constructions. They described the world as they saw it. In modern times, though we have more scientific knowledge of medicine and disease, we continue to understand them through a cultural lens. It is impossible not to! Mass Psychogenic Illness reveals this cultural connection, as do other illnesses that do not have a biological cause, such as eating disorders, gender dysphoria, etc. They are products of our cultural understanding of disease as much as laughing was for Tanganyikans and dancing for Europeans.